| NPI | 1104185487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TN 0000002724) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX T0587) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2021-04-26 |